Several measures that are currently poorly defined in many of our studies that focus on prevention are now a priority for us to achieve the goal of preventing the majority of cancer. These are summarized below and in a recent article (http://bit.ly/aI2jAr)
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Prevention Questions
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Cohort
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Methods issues
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Which exposure?
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Refined measures
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Validation and error correction strategies.
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Change by how much?
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Observational cohorts ideally across broad range of exposure
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Consortium adds value of broader exposure (e.g., EPIC and diet pooling project).
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Among whom? At what age must exposure be changed?
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Level of exposure.
Time course of exposure and disease development
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Consortium adds power to evaluate effects of age. Intermediate endpoints refine temporal relations.
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How long must change be sustained?
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Duration of altered exposure to modify cancer incidence
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Repeated assessment, updating exposure, refines measures of duration and continuing adherence.
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Does risk reduction persist after cessation of exposure?
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Updated exposure in cohort essential to address this question.
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Follow-up of participants after intervention in trail setting adds insights here too.
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